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August 11, 1989

Remodeling the House of Academe

JAMA. 1989;262(6):826. doi:10.1001/jama.1989.03430060122037

In this issue of The Journal, Schroeder and colleagues1 engage in a far-reaching review of American academic medicine. They shower the academic establishment with kudos for its performance in biomedical research, in the development and application of technology, and in progress against specific diseases, and also give us good marks for efforts in screening for preventable disease, in health services research, and in innovations in health care provision. On the other hand, the authors take us to task for our performance in matters of health status, health care costs, quality, manpower mix and distribution, and long-term care and disability and as a training ground for other countries. They argue that because the academic medical center has done well and has received its share of the public purse, it now behooves it to expand its horizons to encompass the problems of the public health; cost control; access for the poor,